Implicit loneliness, emotion regulation, and depressive symptoms in breast cancer survivors

Abstract

Among individuals coping with cancer, emotional approach coping—expressing and processing emotions following negative events— has been identified as a potentially adaptive form of emotion regulation. However, its mental health benefits may depend on social-cognitive factors and on how it is implemented. This study examined loneliness as a determinant of emotion regulation associations with depressive symptoms in women with breast cancer. Loneliness was examined as an implicit social-cognitive phenomenon (i.e., automatic views of oneself as lonely), and emotional expression and processing were examined as both explicit and implicit processes. Approximately 11 months after diagnosis, 390 women completed explicit measures of coping through cancer-related emotional expression and processing; an implicit measure of expression and processing (an essay-writing task submitted to linguistic analysis); and an implicit association test (IAT) measuring loneliness. Depressive symptoms were assessed three months later. Regardless of implicit loneliness, self-reported emotional expression (but not emotional processing) predicted fewer depressive symptoms, whereas implicit expression of negative emotion during essay-writing predicted more symptoms. Only among women high in implicit loneliness, less positive emotional expression and more causal processing during the writing task predicted more depressive symptoms. Results suggest that explicit and implicit breast cancer-related emotion regulation have distinct relations with depressive symptoms, and implicit loneliness moderates effects of implicit emotional approach. Findings support implicit processes as influential mechanisms of emotion regulation and suggest targets for intervention among breast cancer survivors.

Loneliness as a mediator of the relationship of social cognitive variables with depressive symptoms and quality of life in lung cancer patients beginning treatment

“…Loneliness was a statistically significant mediator of the relationship of social cognitive factors with depressive symptoms and quality of life, although some of the direct effect remained. Loneliness has been shown to mediate the relationship between emotional expression and depression in cancer samples, consistent with the finding that loneliness mediates the relationship between social constraint and depressive symptoms . Findings indicate that loneliness mediates the relationship between stigma and depressive symptoms and quality of life, a relationship that has also been observed in HIV‐infected individuals .…”

“…Loneliness has been shown to mediate the relationship between emotional expression and depression in cancer samples, consistent with the finding that loneliness mediates the relationship between social constraint and depressive symptoms. 22,36 Findings indicate that loneliness mediates the relationship between stigma and depressive symptoms and quality of life, a relationship that has also been observed in HIV-infected individuals. 37 This implicates a reduction in loneliness as a mechanism by which intervening with perceived stigma may help to improve lung cancer patients' psychosocial outcomes.…”

Chronic and episodic stress predict physical symptom bother following breast cancer diagnosis

“…The current study involves secondary analysis of data from a longitudinal study examining psychosocial and cancer-related predictors of depression and other outcomes among recently diagnosed breast cancer patients (Bauer et al, 2016; Marroquín et al, 2016; Stanton et al, 2015). Of 823 women approached to participate, 61 were ineligible (8%).…”

Anxiety and Depression in Cancer Survivors

“…Risk factors for depressive symptoms include: In a heterogeneous sample of adult cancer survivors, a diagnosis of melanoma, survivors not in remission, and smoking 33 Females 61 A higher number of comordbid conditions 36,63,74 Negative body image for women 75,76 Financial problems 64,71,77,78 Within the first 2 years of survivorship 79 Prior history of depression 33,35 A sedentary lifestyle 33,35 Loneliness 80 …”